Posters for 2025 G4J (Geriatrics 4 Juniors)

Background This project was conducted within the Urology inpatient department at Leicester General Hospital, led by resident doctors under consultant supervision. Introduction ReSPECT forms summarise personalised recommendations for a patient’s care in an emergency setting, outlining their priorities and fears. Incomplete ReSPECT forms risk inappropriate interventions that do not align with patients’ wishes or clinical needs. Locally, the completeness and quality of ReSPECT forms varied, with missing patient preferences or unclear escalation plans, contributing to miscommunication between

Introduction Prescribing for older adults is complex due to frailty, multimorbidity, altered pharmacokinetics, and high risk of adverse drug reactions. Newly graduated doctors write most inpatient prescriptions but often feel underprepared, with error rates up to 10% (Nazar et al., 2015). Simulated prescribing platforms, such as Better Meds, offer a safe, realistic environment to practice. We designed progressive tutorials within geriatrics placement to address prescribing challenges in delirium and polypharmacy. Method Two cohorts of medical students participated: Year 3 (n=20): During the

Abstract Content : Introduction Fragility fractures are common in older adults and carry a high risk of refracture and mortality. Evidence shows that intravenous zoledronic acid can reduce refracture risk by up to one-third, with early initiation proven safe. Yet, real-world practice is often delayed by factors such as vitamin D deficiency, frailty, and system-level gaps. This audit assessed current practice at our centre and evaluated improvements after service changes. Method A retrospective audit was conducted at Heartlands Hospital. Patients aged ≥60 years admitted with fragility fractures

Introduction Sitting out of bed plays a crucial role in preventing deconditioning, muscle wasting, pressure injuries and thrombosis among older inpatients. It also fosters social interaction and cognitive engagement, reducing hospital stay duration and combating 'PJ Paralysis'. Objective To improve the number of older patients sitting out of bed during lunchtime in the COTE ward, thereby supporting their functional recovery and overall well-being. Methods Direct observations were conducted over two consecutive days at baseline and again three weeks after intervention were implemented. Patients

Introduction Older adults have historically been excluded from research, in part due to preconceived notions from researchers, clinicians and patients themselves about research being for younger patients or those with certain medical conditions. These assumptions persist despite “Healthy Ageing” being a priority theme for the National Institute for Health and Care Research and the extensive body of evidence that involvement in research benefits clinical care for older adults. This quality improvement project (QIP) aimed to improve older adults’ understanding of opportunities for research

Introduction Osteoporosis poses a significant health challenge in older adults, especially due to fragility fractures that increase morbidity and mortality. The FRAX tool, designed to estimate a 10-year risk of major osteoporotic and hip fractures, is a key resource for guiding treatment decisions. This audit evaluated how effectively FRAX scoring and primary prevention strategies were being used in a Front Door Frailty ward. Methods: Two retrospective audit cycles were conducted. The first included 51 patients (May–August 2024), and the second 50 patients (January–April 2025), admitted with

Background General Medical Council (GMC) recommends effective departmental inductions to support doctors to transition and work in complex, unfamiliar situations with sick patients. Acute stroke care is time critical, multidisciplinary, multi-specialty clinical work and requires doctors to fully comprehend and be able to perform assessments and interventions correctly and timely. This requires effective and tailored clinical induction. Introduction In our hospital, stroke medicine induction is delivered in large group teaching as part of geriatric medicine and general medicine induction

Introduction A significant proportion of hospital admissions among the elderly are attributed to falls, contributing to morbidity and mortality. NICE guidelines recommend a comprehensive assessment in elderly patients presenting with fall including lying standing blood pressure (LSBP) test, carrying out structured medications review and osteoporosis risk assessment. While a large proportion of patients are reviewed and assessed by frailty team after hospital admission, there are a considerable number of elderly patients with falls admitted to Acute Medical Unit especially during out-of-hours

Introduction Blood tests are frequently ordered in geriatric wards, often without clear clinical justification. This can lead to patient discomfort, increased costs, and unnecessary workload on staff and laboratory services. This audit aimed to evaluate the frequency and appropriateness of blood test ordering and reduce unnecessary investigations in geriatric wards. Method We reviewed blood tests ordered over a 2-week period across the four geriatric wards at Leicester Royal Infirmary. Seven commonly requested tests were included: full blood count (FBC), urea and electrolytes (U&E), C-reactive

Introduction: Inappropriate polypharmacy is the use of medications with no evidence-based indication, unmet treatment goals, high risk of adverse drug reactions, or when the patient is unwilling / unable to take treatment as intended. This is particularly concerning in geriatric care, due to increased risk of hospital admissions, adverse drug reactions and significant healthcare costs. To address these risks, clinicians should conduct patient-focused medication reviews. This project aimed to assess and improve polypharmacy reviews at Royal Albert Edward Infirmary (RAEI), with a focus on

Introduction Acute heart failure (AHF) is a life-threatening condition that frequently necessitates emergency hospital admission. Intravenous (IV) diuretics, particularly furosemide, are vital in initial management, with early administration shown to improve outcomes. Despite guideline recommendations, delays or deviations in prescribing practices are common. This quality improvement project aimed to assess compliance with European Society of Cardiology (ESC) guidelines regarding the timely administration of IV furosemide in patients with AHF. Method A retrospective audit was undertaken at

Introduction Pain is a common yet under-recognised and debilitating symptom among elderly patients, particularly with dementia, cognitive impairment, or communication barriers. Inadequate assessment can result in adverse outcomes, including reduced mobility, falls, and prolonged hospitalisation. This Quality Improvement Project aims to improve compliance with pain assessment and documentation on acute and frailty geriatric wards. At our hospital, a gap in systematic pain assessment was identified, hence we sought to address this by implementing standardized protocols, enhancing timely

Introduction Iron deficiency anaemia (IDA) is one of the most common reasons for referral to day-case settings, reflecting its significant contribution to global morbidity and disease burden. In 2017/2018, over 100,000 treatments were delivered nationally at a cost of £465 million – averaging £449/ case. Locally in South London, a single trust treats 50-60 patients monthly. In the general population , anemia is defined as a haemoglobin <130g/L in men and <120 g/L in non-pregnant women, in association with a serum ferritin<30 mg/L (in the absence of inflammation).The diagnostic criteria differs

Introduction: Venous thromboembolism (VTE) is a common complication in post-stroke patients, with an incidence of approximately 17%. Pulmonary embolism accounts for 25–50% of reported VTE-related deaths. Pharmacological prophylaxis with low-molecular-weight heparin (LMWH) is contraindicated within the first 30 days following stroke due to the risk of haemorrhagic transformation and clot instability. As an alternative, mechanical prophylaxis using intermittent pneumatic compression (IPC) has demonstrated efficacy in reducing VTE incidence and improving survival outcomes. Evidence from the CLOTS

Introduction: Delirium is a common and serious presentation in older inpatients, associated with increased risk of mortality and long term cognitive impairment. Drugs with anticholinergic properties (DAPs)have been linked to poorer cognitive outcomes, and anticholinergic burden may contribute to the development of delirium. This study explores whether higher Anticholinergic Burden Scale (ACB) scores are associated with delirium in older inpatients referred to Old Age Liaison Psychiatry (OALP) at Nottingham University Hospitals (NUH). Method: All inpatients aged 65 or older referred to OALP at

Intro: Decompensated heart failure is a common acute presentation to hospital amongst the frail older population where treatment often involves intravenous furosemide. Whilst this is effective in inducing a diuresis, it can be associated with negative effects of hospital stay such as hospital-associated infections and deconditioning. Continuous subcutaneous infusion (CSCI) of furosemide is well-established as a palliative treatment for end-stage heart failure and there is growing evidence that CSCI Furosemide is as safe and effective as intravenous in the management of acute episodes of

Effective communication is essential in delivering quality, patient-centred care, yet older inpatients frequently encounter barriers arising from sensory impairment, cognitive decline, and complex co-morbidities1. Evidence suggests inadequate communication contributes to reduced patient satisfaction, delayed discharges and avoidable readmissions2,3. Within local elderly care wards, observations indicated patients often lacked understanding of their diagnoses and were not engaged in decision-making. This project sought to evaluate existing communication practices during ward rounds and

Introduction: This quality improvement project (QIP) was conducted in a busy Emergency Department (ED) in South Wales (Grange University Hospital (GUH)), as part of efforts to improve safety for older patients. Our ultimate goal is to reduce unnecessary re-admissions, as hospital stays can cause rapid deconditioning in older patients. Patients aged over 65 account for 25% of ED attendances (Emergency Care Data Set, 2024). It is well documented for this subset of patients that good handover is crucial to improving overall standards of care, and continuity of care into the community. Standard

Title: Ageing with Confidence; A QI project on Urinary Incontinence Assessment Introduction: UI is a common yet underdiagnosed geriatric problem with a UK prevalence of >20% in individuals aged over 65. Despite its high prevalence, UI often remains untreated negatively impacting the quality of life. Objectives: This project aimed to raise awareness and improve patient outcomes by introducing a standardised urinary incontinence (UI) assessment proforma to aid early recognition and management of UI among elderly patients admitted to the COTE ward in a district general hospital. Methods: A

Introduction Osteoporosis is systematic skeletal disorder causing low bone mass, which increases pre-disposition to fractures. In older adults, fragility fractures are usually the first presentation of this. National Osteoporosis Guidelines Group (NOGG) have published evidenced-based guidelines for identifying and managing bone health in the over 50’s, however compliance can be variable. Methods An EMIS search was conducted of patients at the Surrey practice which identified 46 patients over 50 years old (25 of which were over 70 years old) who had been coded as having had a fragility fracture